NPIMap

Organization Active NPI

Kentwood Dental Associates

  • Dentist
  • Grand Rapids, MI
National Provider Identifier
1194992933
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
17185 Issued in MI
Legal business name
KENTWOOD DENTAL ASSOCIATES
Doing business as
Dental Associates of West Michigan
Practice address
6208 Kalamazoo Ave SE
Grand Rapids, MI 49508-7893
Phone
(616) 554-5970
NPI assigned
May 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Steven M Conlon, D.D.S.
Title
Part Owner
Phone
(616) 554-5970

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 17185 MI Primary

Addresses

Primary practice location

6208 Kalamazoo Ave SE
Grand Rapids, MI 49508-7893

Mailing address

6208 Kalamazoo Ave SE
Grand Rapids, MI 49508-7893
Phone (616) 554-5970

Other names 1

  • Dental Associates of West Michigan Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210550400000",
    "number": "1194992933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6208 KALAMAZOO AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495087893",
            "telephone_number": "616-554-5970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6208 KALAMAZOO AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495087893",
            "telephone_number": "616-554-5970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTWOOD DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-12",
        "last_updated": "2008-05-12",
        "status": "A",
        "authorized_official_last_name": "CONLON",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PART OWNER",
        "authorized_official_telephone_number": "616-554-5970",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "17185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Associates of West Michigan",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.